| NPI | 1861844763 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA WEST Office Manager 423-569-2754 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 0000020552) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 0000016521) |
| Enumeration Date | 2016-07-05 |
| Last Update Date | 2019-06-19 |